33 coder lead jobs found

Job Description Job Description Description: We are seeking a highly skilled and experienced Medical Billing Specialist to oversee all aspects of billing operations at our Ambulatory Surgery Center. The ideal candidate will bring a strong background in coding, billing, collections, and dispute resolution, with the ability to manage a team and optimize financial performance. Requirements: Key Responsibilities Lead and manage the billing team, ensuring efficiency and compliance across all processes. Oversee end-to-end revenue cycle operations, including patient registration, coding, billing, collections, payment posting, and denial management. Ensure accurate coding and billing practices in compliance with federal, state, and payer-specific requirements. Manage surgical physician and facility billing, including implants and accessories. Oversee both in-network and out-of-network billing processes. Navigate and manage federal and state Independent Dispute Resolution...

Job Description Job Description The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned KNOWLEDGE & SKILLS: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology Knowledge of applicable fee schedule and or applicable U&C Guidelines Proficient in Microsoft Office applications Technical aptitude...

Certified Medical Coder (Professional Review Specialist I) The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This is a remote role. Essential Functions & Responsibilities: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned Knowledge & Skills: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology Knowledge of applicable fee schedule and or applicable U&C Guidelines Proficient in Microsoft Office applications...

Job Description Job Description About the Role: The Certified Medical Coder - Manager plays a pivotal role in overseeing the accuracy and efficiency of medical coding and billing operations within a healthcare organization. This position ensures that all medical records are coded correctly according to established guidelines, facilitating proper reimbursement from insurance providers and patients. The manager will lead a team of AR billing specialists, providing training, support, and quality control to maintain compliance with healthcare regulations and payer requirements. Minimum Qualifications: Certified Professional Coder (CPC) or equivalent certification in medical coding. Minimum of 3 years of experience in medical coding and billing, including experience with CPT coding and healthcare reimbursement. Proven experience managing a team or leading projects within a medical coding or billing environment. Strong knowledge of Medicare, commercial insurance billing,...

Job Description Surgical Anesthesia Compliance AuditorCompliance Auditor MUST HAVE CPC CERTIFICATON This is a HYBRID position- MUST be in the office located in Chappaqua, NY 3 days a week. Surgical Anesthesia Compliance Auditor- Hybrid position- Chappaqua, NY- $100K-$115K Are you passionate about healthcare compliance and eager to make a meaningful impact? FlexStaff is seeking a detail-oriented and experienced Compliance Auditor to join our client's dynamic team! This hybrid position offers the perfect blend of in-office collaboration and remote work, all while contributing to an organization committed to excellence in patient care and regulatory adherence. In this pivotal role, you'll leverage your healthcare environment experience-whether as a Certified Professional Coder or similar professional-to audit and monitor clinical records, ensuring accuracy, completeness, and compliance. Your expertise with medical terminology, coding, and documentation will support our...

Experienced Multi-Specialty Surgery Coder The experienced multi-specialty surgery coder is responsible for daily coding, denial management, charge hold, RAI resolution and abstraction. The coder is responsible for escalation of coding questions and requests for coding guidance to the Coding Coordinator and/or Supervisor. Participate in internal QA audits and provide feedback in the compliance QA process. Hours: Monday - Friday, working 40 hours a week Location: Fully Remote - U.S You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Provide coding and abstraction of physician or professional records Provide communications to Coordinator, Supervisors and Managers Complete RAI's, denials, charge hold reports, and coding edits Assist on special coding projects as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear...

Scheduled Hours 40 Position Summary Position reviews medical record documentation to determine appropriate billing codes and necessary documentation. Job Description Primary Duties & Responsibilities: Reviews the documentation in the record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patients conditions and treatment. Codes evaluation and management to appropriate CPT code and codes diagnosis to appropriate ICD-9 code. Meets with physicians to review documentation, resolve coding and secure signature of all unsigned dates of service, tagging files for follow up. Acts as lead person and assists coders with IBC staff with medical terminology and policy interpretation as required. Assists with efforts to increase physician awareness of documentation requirements. Prepares case reports and initiates follow-up for billing process. Working Conditions: Normal office environment. Typically...

Senior Professional Coder The Senior Professional Coder will apply an advanced professional coding skill set to act as a service line coding team lead expert, working collaboratively to support all workflows related to professional fee coding/charging/denials follow-up. Coordinates with others as needed to ensure comprehensive and timely completion of professional coding processes. Audit CPT and ICD-10 diagnosis coding applied by providers and coding staff to assure compliance with federal and state regulations and insurance carrier guidelines. Provide education, instruction and training to providers and coding staff. Act as an expert for the HCC/Risk adjustment coding. This position is remote but does require onsite education to providers as needed. Essential Duties and Responsibilities Review, analyze, and validate CPT and ICD-10 diagnosis codes and charges applied by providers to assure compliance with federal and state regulations and insurance carrier guidelines. Ensuring...

Senior Medical Coder The Senior Medical Coder plays a critical role in supporting clinical trials by ensuring the accurate, consistent, and timely coding of medical terms using standardized dictionaries (e.g., MedDRA, WHO Drug). This individual brings advanced knowledge of medical terminology, clinical trial processes, regulatory requirements, and coding best practices. The Senior Medical Coder serves as a subject matter expert and collaborates cross-functionally with clinical operations, data management, safety/pharmacovigilance, biostatistics, and medical writing teams to maintain high-quality data that meet global regulatory standards. Medical Coding Perform complex medical coding for adverse events, medical history, procedures, and concomitant medications using MedDRA and WHODrug dictionaries. Review and validate coding performed by other coders to ensure consistency and accuracy. Identify ambiguous or unclear terms and query clinical sites or data management for...

Surgical Anesthesia Compliance AuditorCompliance Auditor MUST HAVE CPC CERTIFICATON This is a HYBRID position- MUST be in the office located in Chappaqua, NY 3 days a week. Surgical Anesthesia Compliance Auditor- Hybrid position- Chappaqua, NY- $100K-$115K Are you passionate about healthcare compliance and eager to make a meaningful impact? FlexStaff is seeking a detail-oriented and experienced Compliance Auditor to join our client's dynamic team! This hybrid position offers the perfect blend of in-office collaboration and remote work, all while contributing to an organization committed to excellence in patient care and regulatory adherence. In this pivotal role, you'll leverage your healthcare environment experience-whether as a Certified Professional Coder or similar professional-to audit and monitor clinical records, ensuring accuracy, completeness, and compliance. Your expertise with medical terminology, coding, and documentation will support our mission to uphold...

Medical Coder Job Duties: Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications. Researches and analyzes data needs for reimbursement. Analyzes medical records and identifies documentation deficiencies. Serves as resource and subject matter expert to other coding staff. Reviews and verifies documentation supports diagnoses, procedures and treatment results. Identifies diagnostic and procedural information. Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes. Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines. Follows coding conventions. Serves as coding consultant to care providers. Identifies discrepancies, potential quality of care, and billing issues. Researches, analyzes, recommends, and facilitates plan of action...

Req Number 174853 Lead Compliance Auditor - Heavy Anesthesia & Healthcare Expertise Needed. This is a HYBRID position- MUST be in the office located in Chappaqua, NY 3 days a week. Are you a seasoned compliance professional with a passion for anesthesia and healthcare auditing? Do you thrive in fast-paced environments where your expertise can make a real impact? FlexStaff is seeking a dynamic, detail-oriented Lead Compliance Auditor to join our client's team and lead the charge in safeguarding healthcare integrity and regulatory excellence! Position Summary: As a Lead Compliance Auditor, you will leverage your extensive anesthesia auditing experience to oversee comprehensive compliance reviews, develop training programs, and collaborate with senior leadership to enhance our compliance framework. Your expertise will ensure the organization remains at the forefront of regulatory adherence, risk mitigation, and quality improvement. Ready to make a difference in...

A prominent healthcare organization is seeking a Lead Compliance Auditor specializing in anesthesia to ensure regulatory adherence and quality improvement. This role involves leading audits, developing training programs, and collaborating with senior leadership. Ideal candidates will have over 10 years of experience in healthcare compliance auditing, exceptional communication skills, and a deep understanding of anesthesia coding and billing standards. This hybrid position requires office presence in Chappaqua, NY, three days a week. #J-18808-Ljbffr

Senior Inpatient Coder – Westchester Medical Center Health Network Senior Inpatient Coder is responsible for addressing appeals to insurance companies and coding highly complex medical records using the current International Classification of Diseases (ICD10 CM/PCS codes) and entering coded information into an automated grouper system. Technical guidance and acting in a lead role is expected. Responsibilities Addresses appeals to insurance denials to facilitate expedient resolution and reimbursement. Interprets and applies American Hospital Association Official Coding guidelines to articulate and support principle and secondary diagnoses and selected procedures. Identifies and analyzes patterns in possible coding errors or other trends and reports to the coding leadership team. Participates in mandated medical record review processes. Using current ICD10 CM/PCS coding systems, assigns and records an accurate code to all diagnoses, procedures and operations as documented by...

Lead Compliance Auditor - Heavy Anesthesia & Healthcare Expertise Needed. This is a HYBRID position- MUST be in the office located in Chappaqua, NY 3 days a week. Are you a seasoned compliance professional with a passion for anesthesia and healthcare auditing? Do you thrive in fast-paced environments where your expertise can make a real impact? FlexStaff is seeking a dynamic, detail-oriented Lead Compliance Auditor to join our client's team and lead the charge in safeguarding healthcare integrity and regulatory excellence! Position Summary: As a Lead Compliance Auditor, you will leverage your extensive anesthesia auditing experience to oversee comprehensive compliance reviews, develop training programs, and collaborate with senior leadership to enhance our compliance framework. Your expertise will ensure the organization remains at the forefront of regulatory adherence, risk mitigation, and quality improvement. Ready to make a difference in healthcare compliance...

Job Description Lead Compliance Auditor - Heavy Anesthesia & Healthcare Expertise Needed. This is a HYBRID position- MUST be in the office located in Chappaqua, NY 3 days a week. Are you a seasoned compliance professional with a passion for anesthesia and healthcare auditing? Do you thrive in fast-paced environments where your expertise can make a real impact? FlexStaff is seeking a dynamic, detail-oriented Lead Compliance Auditor to join our client's team and lead the charge in safeguarding healthcare integrity and regulatory excellence! Position Summary: As a Lead Compliance Auditor, you will leverage your extensive anesthesia auditing experience to oversee comprehensive compliance reviews, develop training programs, and collaborate with senior leadership to enhance our compliance framework. Your expertise will ensure the organization remains at the forefront of regulatory adherence, risk mitigation, and quality improvement. Ready to make a difference in...

Coding Position Overview Apply the appropriate diagnosis and/or procedure codes to individual patient health information for data retrieval, analysis, and claim processing for Facility outpatient accounts, facility-based procedural coding and physician practice specialty/surgical coding. Code assignment should be done in accordance to coding and reimbursement guidelines with minimal errors. Primary Department, Division, or Unit Primary Work Shift: Day Regular Scheduled Weekly Hours: 40 Compensation Range: $22.97 - $34.46 per hour, depending on experience Education/Experience Minimum Required: + RHIT certification with an Associate's Degree in HIT; or CPC, CCA, CCS-P, or CCS certification with an Associate's Degree or High School Diploma or equivalent; or a High School Diploma and one year of coding experience. + If applicant does not possess above noted credentials, must obtain their credentials within 6 months of start date. Preferred: + RHIA certification with a Bachelor's...

Hospital Coder The Hospital Coder applies skills and knowledge of currently mandated coding and classification systems, and official resources to select the appropriate diagnostic and procedural codes (including applicable modifiers), and other codes representing healthcare services (including substances, equipment, supplies, or other items used in the provision of healthcare services). This position is responsible for selecting and sequencing the codes such that the organization receives the optimal reimbursement to which the facility is legally entitled, remembering that it is unethical and illegal to increase reimbursement by means that contradict requirements. Essential Duties And Responsibilities: Use a computerized encoding system to facilitate accurate coding. Sequence diagnoses and procedures by following the ICD-10-CM/PCS, CPT4, Uniform Hospital Discharge Data Set (UHDDS), Medicare, Medicaid and other fiscal intermediary guidelines. Support the reporting of...

Coding Specialist Reviews inpatient clinical documentation to determine the appropriate assignment of alpha numeric diagnosis/procedure codes and Medicare Severity Diagnosis Related Groups (MS-DRG). Data is classified for internal and external statistical reporting, research, regulatory compliance and reimbursement. Codes high dollar and more complex accounts including but not limited to, medical, surgical behavioral health, IP Rehabilitation and others. Position Responsibilities Key Areas of Responsibility Coding Applies strong knowledge of anatomy and physiology, clinical disease processes, pharmacology, and diagnostic and procedural terminology to determine the appropriate assignment of diagnosis and procedure codes for more complex accounts. Analyzes medical records using the Uniform Hospital Discharge Data Set (UHDDS), interprets documentation and assigns proper International Classification of Diseases, Tenth Edition, Clinical Modification (ICD-10-CM) diagnoses...

Job Description Job Description Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part...

Associate Director, Publications As an Associate Director, Publications, you will play a strategic role in the development, management and dissemination of our global publication plans. This includes the execution of publications including but not limited to clinical, HEOR/RWE, PKPD, and disease state. Responsibilities will include leading cross-functional publication teams to develop, manage, and implement publication plans for our therapeutic areas. You will be expected to participate in cross functional meetings, monthly core publication team meetings, present at regular strategic meetings, workshops and relevant alliance meetings needed to build and refine publication plans ensuring partners are aligned and updated. This position is located at our Sleepy Hollow, NY office with a requirement to be on-site 4 + days/week. If eligible, we can offer relocation benefits. We cannot offer a hybrid or fully remote option. A typical day may include the following: Partner in the...

Coding Specialist Location Detail: 9 Farm Springs Rd Farmington (10566) Shift Detail: 100% Remote Position Work where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network. The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization. With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system. Position Summary Reviews inpatient clinical documentation to determine the appropriate assignment of alpha numeric...

Coding Team Member We know it's not just about finding a job. It's about finding a place where you are respected, valued, and where your work is purposeful and fulfilling. At CHS, our coding team recognizes your individual talents, encourages professional development, and provides opportunity for career advancement. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 14 states, CHS is committed to helping people get well and live healthier. CHS operates 70 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. Job Summary As a member of the 100% US Based HIM Central Services coding team, the Coder IP provides inpatient coding assistance for a set of HIM Central Services-supported CHS...

Coding Specialist Reviews inpatient clinical documentation to determine the appropriate assignment of alpha numeric diagnosis/procedure codes and Medicare Severity Diagnosis Related Groups (MS-DRG). Data is classified for internal and external statistical reporting, research, regulatory compliance and reimbursement. Codes high dollar and more complex accounts including but not limited to, medical, surgical behavioral health, IP Rehabilitation and others. Position Responsibilities Key Areas of Responsibility Coding Applies strong knowledge of anatomy and physiology, clinical disease processes, pharmacology, and diagnostic and procedural terminology to determine the appropriate assignment of diagnosis and procedure codes for more complex accounts. Analyzes medical records using the Uniform Hospital Discharge Data Set (UHDDS), interprets documentation and assigns proper International Classification of Diseases, Tenth Edition, Clinical Modification (ICD-10-CM) diagnoses...